When your blood sugar climbs higher than normal, but not so high that you fit the definition of diabetes, we say that you have prediabetes. It’s very common — an estimated 86 million Americans have prediabetes and another 120 million have actual or frank diabetes.
So prediabetes isn’t an actual disease so much as a warning sign. Getting a prediabetes diagnosis doesn’t mean you’re guaranteed to progress to full on Type 2 diabetes, which brings heightened risks of heart disease, kidney disease, nerve damage and more.
The good news is if you’re motivated now to make some simple lifestyle adjustments, you can reverse prediabetes and live a healthy life.
How is prediabetes diagnosed?
Prediabetes is a laboratory diagnosis. Most commonly it’s detected when a routine blood test shows that your fasting blood sugar is elevated. Other tests that may detect prediabetes are a hemoglobin A1c, which measures your average blood sugar over the preceding several weeks, and a glucose tolerance test, in which your blood sugars are sampled at various times after consuming a large quantity of sugar. Most patients do not have any of the typical symptoms we associate with diabetes, such as increased thirst, increased urination or blurry vision.
Why is high blood sugar bad for you? The answer to this question still isn’t fully understood, but we do know that a high blood sugar can itself be harmful and is associated with many other metabolic abnormalities — such as resistance to the hormone insulin and elevated blood lipids — that together can damage your blood vessels, nerves and pretty much every organ in your body. Patients with prediabetes are at risk for these complications, but less so than those with actual diabetes.
What causes prediabetes?
Prediabetes results from a combination of genetic and environmental factors. You can’t do much about the former, such as a family history of diabetes, or being a member of an ethnic or racial groups (Black, Hispanic, Native American, Pacific Islander or Asian American) who is diagnosed with diabetes at a higher rate than the rest of the population.
But you can dramatically alter the latter. The main lifestyle habits that can set you up for prediabetes include:
- Becoming overweight
- Physical inactivity
- Inadequate or poor quality sleep
Women with a history of gestational diabetes are also at increased risk for prediabetes, as are women with polycystic ovarian syndrome (PCOS) and anyone with sleep apnea.
What is the treatment for prediabetes?
The goal of treating prediabetes is to return the blood sugar to normal and prevent the development of actual diabetes. This can be accomplished with a combination of lifestyle changes, and medication, if necessary. As you can see from the list of causes, achieving this goal is largely in your hands, and your health care provider can help!
Losing weight, even a few pounds, can make a huge difference. This is best achieved through a healthy diet that includes lots of leafy green vegetables, fruit and lean proteins diet and regular exercise. If you’re getting enough sleep but still feeling tired every day, you may have a sleep disorder that can be diagnosed in a sleep lab. And finally, of course, if you’re a smoker you must stop. Your health care provider can help you achieve all of these goals.
For certain patients, primarily those who are significantly overweight and in whom lifestyle changes have not successfully lowered the blood sugar, medication can be considered. The one used most often is metformin, which helps lower blood sugar levels.. There is as yet no compelling evidence that any alternative supplements — e.g. herbs or vitamins — are effective.
Prediabetes is a risk factor for developing actual diabetes, but it’s one that can almost always be successfully managed through lifestyle adjustments. Look at it not as a disease but as a warning sign, one that if addressed can lead to a healthier, happier and longer life.
Learn more about the healthy habits that can help reverse prediabetes and how your health care provider can support you in Your Guide to Managing Prediabetes.